So I had my first session at the Egoscue Clinic in San Francisco last Tuesday. The clinic is conveniently located, practically upstairs from the BART Montgomery station. You can't really tell from the photos on their website, but the space is open and airy, with lots of light.

I met my therapist (A.B.) and we had the "so, what brings you in today?" conversation. After reviewing my history, it was time for the moment of truth: the photos. When you go to an Egoscue Clinic, one of the diagnostic/evaluative tools they use is a digital camera. (Used to be a Polaroid, but they've moved on with technology.) They take four photos of you (front, back, side & side), then superimpose a plumb line before printing them out. This forces allows one to see just how badly misaligned and skewed one is.

It would be good for me to open up my binder and look at the photos again, because when I first saw them my brain went into "AIEEEEE I LOOK LIKE A CRESCENT MOON WHEN I STAND UP ACK ACK ACK!" and I think I might not have really evaluated them calmly and coolly. In any event, they show that I am indeed badly misaligned; my right hip is higher than the left, my right foot everts, and the entire pelvis is out of vertical alignment (too far to the right). "Your right hip is having to work much harder than the left," A.B. said, "which is causing the pain in your back and your leg."

She also had me walk back and forth across the carpet several times, to get a sense of how I move when I walk. And how do I move when I walk? Answer: not enough. My shoulderblades and thoracic spine are held tight and locked up (probably from being braced against the pain), which impairs the ability of my arms to swing freely when I walk. And my right foot slaps down to a much greater degree than the left.

Next she put me into the Static Back exercise position (lie on your back with your calves up over a block or chair, legs up at 90 degrees from the torso, knees at 90 degrees) for a bit while she put together my first menu of E-cises. She took me through all the exercises on my menu to see how I did with them and give me pointers on form, and rearranged the order of a couple because of my particular misalignment issues.

After that, and once I'd put my shoes back on, we went over the binder of things she was giving me to take home. It includes a listing of my E-cise menu, plus detailed descriptions (including photos) of each E-cise, plus (ack!) my diagnostic photos.

I was very pleased with the experience. The space is lovely and conducive to the kind of work they're doing; the people who work there all seem friendly and competent; and my pain is SIGNIFICANTLY reduced. We wound up signing up for the 16-visit Friends & Family package so spiritualmonkey and I can both get fixed up and functional again.

I've been doing my menu every day since then, and the difference is PHENOMENAL. I graphed my painkiller use since April 1, just to get a visual (before April 1, it looked much the same, except the values were more in the 4, 5, and occasionally 6 range):

Egoscue.com seems to be pretty light on actual explanation for what exactly they do, but the basic idea seems more or less sound. Exercise, range of motion, etc.

The only thing that seems a little crazy is the price - $250 for the visit, $175 each after the first 8 visits. I know lawyers who work much cheaper than that. Seems a bit much, especially with spiritualmonkey's recent do-it-yourself "you don't need to join a fancy gym if you've got your own big iron weight" approach. It's great that this is so effective but it seems possible to achieve the same result without the huge cash outlay, especially if you guys are trying to save money.

I checked PubMed and I get exactly six results for "Egoscue", five of which involve the breeding of southern-hemisphere rats. That's about as inconclusive as results get. :)</cite>

I've got a different take on the price than the previous comment maker has. This is on part with physical therapy and the cost is pretty much in line with PT. Most people don't know what PT costs, because they pay their insurance co-pay and that's it.

Between overhead, equipment, liability insurance, continuing education, certification requirements, licensing requirements, rent, space, non-therapeutic staff, a biller (or other financial person) and therapists, it probably breaks town such that the actual person you are working with is being paid a rate relatively consistent with that of a massage therapist.

And, if it's getting out of pain? Fantastic. If it's going to help you correct chronic issues and, hence, prevent lots of future wear and tear (and pain)? Priceless.

Hey, Lexi, did your therapist talk about Conditions I, II and III and say which one you were? I have Egoscue's first book and am still trying to diagnose myself. I think I need to work out some kind of visual marker with plumb lines or something because I'm not seeing the rotation/eversion stuff I'm pretty sure I must have. I'm just seeing knock knees. :/